An Experimental Study on Portal Vein Chemotherapy as a Prophylactic Treatment Against Liver Metastases

Hideyuki Ishida, Takeo Iwama, Yoshinobu Nishioka, Yasushi Okubo, Mahito Iwajo, Yoshio Mishima

Second Department of Surgery, Tokyo Medical and Dental University

This study was conducted in male Donryu rats to investigate the role of portal vein chemotherapy for prevention of liver metastasis. Continuous mesenteric venous infusion of 5-Fu (20 mg/kg/day) resulted in a high portal vein level (5.3±1.3 µg/ml) and a low caudal vein level (0.41±0.12 µg/ml) of 5-Fu, whereas a low portal vein level (0.62±0.23 µg/ml) and a high caudal vein level (0.91±0.31 µg/ml) were detected 6 hours after continuous femoral venous infusion. To evaluate the ability to prevent liver metastasis, Donryu rats (180-200 g) receiving intraportal inoculation of ascites hepatoma AH60C (4×10⁶ cells) were randomly assigned to 4 groups. Group A; continuous portal venous infusion of 5-Fu (20 mg/kg/day) heparin (100 u/kg/day). Group B; continuous femoral venous infusion of 5-Fu+heparin. Group C; continuous portal vein infusion of heparin. Group D; Control. Infusion was started on the same day as tumor inoculation and maintained for 5 days. The volume of metastases on day 21 was calculated in each group. The tumor volume of Group A exclusively showed statistically significant reduction compared with that of the other groups. In conclusion, continuous portal venous infusion of 5-Fu was considered to be effective against liver metastasis by preventing the lodging of tumor cells in the intrahepatic portal system.

Key words
prevention of liver metastasis, prophyractic portal vein chemotherapy, 5-fluorouracil, Heparin, cancer of digestive organs

Reprint requests
Hideyuki Ishida Second Department of Surgery, Tokyo Medical and Dental University
1-5-45 Yushima, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
October 9, 1991

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